Individual
EDWARD SHAKHBAZYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
(818) 788-1003
Mailing address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5635
CA
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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